Wellspring Counseling Center of Southern Oregon, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

WELLSPRING COUNSELING CENTER OF SOUTHERN OREGON, LLC

Practice address

18 Portland Ave.
Medford, OR 97504-7309

Phone

(541) 857-0873

Fax

(541) 245-1530

NPI assigned

May 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bernie Legner, ED.D., LMFT

Title

Owner

Phone

(541) 857-0873

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1780894840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PORTLAND AVE.",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047309",
            "telephone_number": "541-857-0873",
            "fax_number": "541-245-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PORTLAND AVE.",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047309",
            "telephone_number": "541-857-0873",
            "fax_number": "541-245-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING COUNSELING CENTER OF SOUTHERN OREGON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "LEGNER",
        "authorized_official_first_name": "BERNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-857-0873",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ED.D., LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Medford, OR
• Providers in Medford, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.